New Rule on Medical Record Confidentiality

Physicians will have 2 years to develop the consent forms andcompliance programs dictated by the medical records confidentiality rulepublished by the Clinton administration on December 28. Some provider groups,particularly in the health insurance industry, want the Bush administration toreview and change elements of the final rule, but that is very unlikely tohappen. Not only will oncologists have to get a consent form signed before thepatient can be seen for the first time, but they will also have to give thepatient a form that includes a "detailed discussion of the provider’shealth information practices." That form must tell the patient that he orshe has the right to ask the doctor to request certain restrictions as to howinformation about the patient will be used or disclosed. Moreover, oncologistswill have to develop a compliance program to make sure that they don’t send apatient’s protected information to someone who is not cleared to receive it.

Christian Downs, director of provider economics and publicpolicy for the Association of Community Cancer Centers, said the requirementswill "demand a lot" from office-based (as opposed to hospital-based)oncologists. "Much of what is required is outside the expertise of theoffice manager, and what needs to be done will not be compensated for,"said Mr. Downs. The Department of Health and Human Services estimates thatfirst-year costs for office-based physicians will be $3,700, with succeedingyear costs at $2,000.